After An Above The Knee Amputation In Children

AMBULATORY CARE:

After an above the knee amputation,

it is important to care for your child's residual limb every day. Healthcare providers will show you how to wrap the limb and care for your child's skin.

Physical and occupational therapy:

A physical therapist will help your child with exercises to improve his or her strength. Your child may be fitted with a prosthesis. It may need to be adjusted several times before it fits well. Physical therapists will also help your child learn to walk with the prosthesis and with crutches. Occupational therapists will help your child adjust to daily activities at home and work.

Care for your child's residual limb:

Clean and care for your child's skin. When your child is allowed to bathe, gently wash around the incision with soap and water. It is okay to let soap and water run over the incision. Have your child take showers instead of baths. Do not let your child soak in a tub or hot tub or swim. These could cause an infection. Your child's healthcare provider will tell you when it is okay for your child to do these activities again. Carefully rinse and dry your child's skin. Look closely at the skin on the residual limb every day. Look for redness, blisters, or scrapes. Do not put lotion, oil, cream, or rubbing alcohol on the residual limb. Rubbing alcohol dries and cracks the skin.

Prevent infection. Have anyone who cares for your child wash his or her hands before touching the wound. This will help prevent an infection. Only use antiseptic (germ-killing) medicines if healthcare providers tell you to.

Help your child's residual limb heal. Help your child push the residual limb against a soft pillow. Slowly increase the pressure and start to push the residual limb against harder surfaces, such as the back of a chair. Massage the residual limb to soften the scar, decrease tenderness, and improve blood flow.

Activity:

Have your child start exercising his or her leg and residual limb as soon as healthcare providers say it is okay. Your child will need to lift his or her leg off the bed and move it in big circles. This helps strengthen the leg, and may prevent blood clots from forming. He or she will repeat this movement with the residual limb.

Have your child slowly increase his or her activity level. Your child should rest when needed but try to exercise 2 to 3 times each day or as directed by a healthcare provider. Do not let your child put weight on the residual limb until healthcare providers tell you it is okay. Many companies supply sports equipment for people with amputations. Talk to your child's healthcare provider about a prosthesis so he or she can stay active in sports.

Ask your healthcare provider when your child can return to work or school. Ask when your adolescent can begin to drive.

Wrap your child's residual limb:

Wrap the limb to help form it into a firm cone shape so it will fit a prosthesis. Keep the bandage on at all times except when your child bathes. Rewrap the residual limb 2 to 3 times each day to keep the bandage smooth and tight. At first you will not pull the elastic bandage very tight. Healthcare providers will have you pull the bandage tighter as your child's wound heals and the stitches are removed. If the residual limb hurts or throbs, the bandage may be too tight. Unwrap your limb and start over. The following are directions for the figure of 8 method to wrap the residual limb:

Hold the bandage roll at your child's waist with one hand. Use the other hand to roll the bandage all the way around his or her waist.

Turn the bandage so that it goes down toward the floor. Roll it diagonally down your child's thigh, and continue to the back of the limb. Stretch the bandage slightly while you wrap the limb.

Roll the bandage around to the front of the limb. Roll it diagonally up your child's thigh, to his or her waist. Roll it all the way around your child's waist again, in the same direction as the first time.

Repeat these steps until the bandage covers the top of your child's thigh to the end of the limb. Overlap the bandage as you wrap so you cover new skin each time. If you need to use more than one bandage, secure each bandage with a clip or tape before you apply another.

When you are finished, secure the last bandage. Try to end the bandage in a place that is not in a skin fold or at your child's hip.

Woolen residual limb socks:

Have your child wear woolen residual limb socks when healthcare providers say he or she no longer needs to wrap the residual limb. This keeps the residual limb clean and comfortable. Wash the woolen socks gently in cool water and soap to keep them from shrinking. Dry the socks flat on a towel to prevent stretching. Replace the sock if it gets torn.

For support and more information:

Follow up with your child's healthcare provider or orthopedist as directed:

Your child may have a home health care nurse help him or her between visits. Your child may need to return to have his or her stitches removed. Write down your questions so you remember to ask them during your visits.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.